Monday, August 28, 2017

Our Sensory Processing Symptoms

During our time in Vancouver, I have learned so much more about the sensory processing struggles HD faces on a daily basis. Everyone is aware of our five senses - taste, touch, hearing, sight, and smell, but there are three more senses the rest of the world is a little less knowledgeable about - vestibular, proprioception, and interoception. When our bodies get too much or too little of a sense, our behavior seems to mirror it. In learning about HD, I've also learned quite a bit about myself too!

Let me take just a moment to catch you up to speed about those three other, less spoken about, senses. 

Our vestibular system helps us to understand what our bodies are doing when related to movement, gravity, and balance. This system makes us aware that we are laying down or sitting up, in an elevator moving up or down, and allows us to walk on, say, a log. Our proprioceptive sense allows us to know where our body parts are and how to plan our movements. We can clap our hands together with our eyes closed, and we know how much force to use when pressing keys on a keyboard, or writing on paper because of this sense. Our interoceptive system is the one that tells us we're hungry, we need to go to the bathroom, our heart is racing, etc. 

When these eight senses are working together correctly, we have an "optimum state of arousal" but when our sensory processes aren't in balance, our bodies can have a sensory overload or low arousal. HD is what the OT world considers a seeker. For HD when he becomes "unregulated" or in a heighten state of arousal, he is often looking for more proprioceptive input - this is when he can be found throwing himself on ground, jumping off the bed onto the mattress, wrestling with his brother, pushing/shoving, etc. (It's also when his listening ears turn completely off.)

Sensory processing disorders appear differently in every person. Some kids can be deemed picky eaters when they have a limited number of foods they'll eat, other kids have a rough time with loud sounds or noisy areas, and some are very particular with their clothes and how they feel on their bodies. Kids who may have over-responsive vestibular systems may cause them to not like swings, slides or merry-go-rounds or may appear clumsy, and other kids with under-responsive vestibular systems might really enjoy being tossed the air, or appear to always be on-the-go or be able to spin in circles for ever and not feel dizzy. (These don't even scratch the surface! If you want more examples, check out this list.)

Usually sensory processing disorders (SPD) are diagnosed along with either autism or ADHD. It's not normally a diagnoses in of itself, but professionals in the OT world are advocating for it to be a stand-alone diagnosis. HD doesn't have autism, and because he hasn't been diagnosed with ADHD, it's been hard to get any extra help for him. Remember his doctor? He's a boy, he'll grow out of it. He's not going to grow out of it - we're just going to teach him how to live with it in an acceptable way. Right now that means going to occupational therapy once a week for an hour. We also have a ton a of tools to use during school!

As I said earlier, HD would be considered a seeker, meaning he under-registers his senses. Using the check list above from, this is a list of the struggles HD has, often on a daily basis.

Hyposensitivity to Touch (Under-Registers)
*may be self-abusive; pinching, biting, or banging his own head (HD used to frequently hit himself in the head, laughing hysterically, over and over)
*frequently hurts other children or pets while playing
*thoroughly enjoys and seeks out messy play

Hyposensitivity to Movement
*in constant motion, can't seem to sit still
*craves fast, spinning, and/or intense movement experiences
*could spin for hours and never appear to be dizzy
*loves the fast, intense, and/or scary rides at amusement parks
always jumping on furniture, trampolines, spinning in a swivel chair, or getting into upside down positions
* is a "thrill-seeker"; dangerous at times
*always running, jumping, hopping etc. instead of walking
*likes sudden or quick movements, such as, going over a big bump in the car or on a bike

Proprioception Seeking Behaviors 
*seeks out jumping, bumping, and crashing activities
* bites or sucks on fingers and/or frequently cracks his/her knuckles
*loves to be tightly wrapped in many or weighted blankets, especially at bedtime
*enjoys bear hugs
*excessive banging on/with toys and objects
* loves "roughhousing" and tackling/wrestling games
*frequently falls on floor intentionally
*would jump on a trampoline for hours on end
*chews on pens, straws, shirt sleeves etc.
*frequently hits, bumps or pushes other children

Hyposensitivity to Sound 
*appears to "make noise for noise's sake" (This one drives me CRAZY!)
*loves excessively loud music or TV
* seems to have difficulty understanding or remembering what was said
*needs directions repeated often, or will say, "What?" frequently

Hyposensitivity to Visual Input
*has difficulty telling the difference between similar printed letters or figures; i.e., p & q, b & d, + and x, or square and rectangle
*has difficulty locating items among other items; i.e., papers on a desk, clothes in a drawer, items on a grocery shelf, or toys in a bin/toy box
*often loses his/her place while reading or doing math problems

Auditory-Language Dysfunction
*difficulty reading, especially out loud
*if not understood, has difficulty re-phrasing; may get frustrated, angry, and give up
*often talks out of turn or "off topic"
*difficulty putting ideas into words (written or verbal) (Writing his thoughts is a huge struggle at school right now. I've been wondering if he might have dysgraphia which deals with writing, unlike dyslexia deals with reading.)
*looks at others to/for reassurance before answering

While HD under-registers most of his senses, it is possible to over-register one sense and under-register another and be both hyposensitive and hypersensitive. I have learned I am very hypersensitive to sounds. Here's what I can check off on the list:
* distracted by sounds not normally noticed by others; i.e., humming of lights or refrigerators, fans, heaters, or clocks ticking (I'm sitting here listening to Perry's Grandfather clock ticking and it annoys me to no end. He wonders why I don't like him to wind it...)
* frequently asks people to be quiet; i.e., stop making noise, talking, or singing (Sorry kids, it's not you, it's me.)
* may refuse to go to movie theaters, parades, skating rinks, musical concerts etc. (Movie theatres kill me. So much sound!)
* may decide whether they like certain people by the sound of their voice (Not proud, but guilty...)

This particular sensitivity of mine makes parenting a kid who likes to make sound because he can, just a little challenging. But seriously, you should hear some of the sounds HD makes. We went to the zoo and he whipped out his monkey call, and people legit thought it was the monkey. I also have no need to carry an air horn around because HD can nail the air horn sound. Impressively annoying. I have to give him props but... We also had a couple bells show up at our house and I'm seriously considering hiding them because just one ding is too many for me. It sends me into a rage. Make it stop, make it stop right now!

What about you guys, do you have any sensory problems? It's more common than you think! 

Friday, August 4, 2017

OT in Vancouver + Zone Regulation

The first few weeks after the move were a whirlwind between unpacking and getting the kids registered for school and then having snow days on top of it all. It was chaos around here.

One thing I super love about their new school is the amount of papers sent home with them about activities in the area. They bring home information on swimming lessons, dance programs, soccer league, basketball sign-ups, day-camps, etc. It is so helpful, especially being brand new to the area and not knowing what all is available and where to go to sign them up for the extra things. One of the papers sent home was a flyer for flag football, which HD really really really wanted to do. We agreed to sign him up, but to do so, he needed a sports physical. That gave me some motivation to get him into the doctor so we could begin the process of finding another occupational therapy place.

By the end of January, HD and JP were signed up for flag football, and HD had a referral sent off for more OT. A few short weeks later, our insurance had approved a place which had an opening for OT so I jumped on it. Then came the stack of papers to fill out and questionnaires to answers. (It's seems never ending!)

As therapy was winding down in Missoula, I was given a handout on implementing a sensory diet for HD but we never discussed it in full as we had other more pressing issues to tend to. On one of the questionnaires I filled out in Vancouver, I had noted several auditory things I had been seeing with HD in the last several weeks/months. Such things included him *always* making noise, simply because he could. He loves loves loves to listen to his music loud - like I can hear his headphones blaring in the front of the car when he sits in the back. He frequently forgets what has just been said too. His OT took note and asked me at the end of his first session if he usually has a blank stare about him, like you're talking through him, to which I lit up YES! ALL THE TIME! Turns out these auditory things that I noted are just a piece of his SPD, specifically an auditory processing disorder where he is under-responsive to sounds.
HD has been enjoying playing in the big gym at OT. (I had to fight the urge to climb into one of the trapezes - they look so comfortable!) In this activity, he was not knowingly, working on perseverance, listening to directions, and following rules. She had his several Star Wars guys around the gym and he couldn't touch the floor but had to find them all. Some gave him special powers, like being able to touch the ground for three seconds at a time. He was really frustrated at the end because he couldn't find them all, but he was able to push through with some help.

Color Zones of Regulation - ThingLink
In our first few weeks at OT, we picked up where we left off when it comes to our emotions. Being able to name our emotions is huge so we've been spending a lot of time at home naming how we're currently feeling, myself included, and then giving an example of what we can do to get out of the zone we are currently in. For example, I might say, "You know, I'm feeling like I'm in the blue zone right now because I'm tired. I think I'm going to take a quick walk around the block to wake up so I can get back into the green zone." Ms. Gail has became an "emotions queen" and is quick to point out who is in what zone at what time. Usually when I ask HD what zone he's in, he would be in the yellow zone because he'd be bouncing around out of control, and just overall being reckless. When he gets into this zone, it can be quite a challenge to get him out of it, especially if we are in a public place -like the other day at the dentist. Or several weeks ago when I took the kids to have dinner at a restaurant with grandma and he couldn't sit in his seat to save his life. I literally wanted to curl up into a ball and ugly cry. 

At home we do have several tactics we use to get him back in to the green zone. I let him take out his energy on building himself a "break spot" which is a fort in a quiet spot of the house, even though it usually causes quite the mess. The dark is really calming for him. But I can't just put him in a closet and be like, calm down dude. He has to want to do it. I recently made a weighted blanket for him, and let him pick out the fabric, and he often uses it at bedtime to help calm his body. We even pull it out in the daytime when we're relaxing and watching tv. HD also loves listening to music so having him wear his mp3 player around the store helps to keep him in check.

He's been getting SO GOOD at being able to label what zone he's in, and then successfully get himself back down to the optimal green zone. I'm going to go on a long tangent and try to paint a picture of my afternoon for you. Last month I took the kids to the library, by myself and it's not something I particularly enjoy doing but we had some books that were due that day so we had to suck it up and go after school. Honestly just getting from the parking lot to the entrance is a struggle for me. With all of them. We can't seem to walk. EVER. We go over expectations (which was recommended by HD's OT) before we get out of the car - typical things like, we need to use our walking feet and quiet voices, stay together, etc. I'm not asking the world of them. But out of the car and onto the sidewalk we go, and the foot race begins. Before we're even half way there, all three have ran ahead and I'm speed walking behind with a stack of books.

When I catch up to them, they are in the revolving door running it around, while people are attempting to enter and exit it. Once they've all cleared the circular door, they make a beeline to the second floor where the kids book are, until I whisper-shout at them to come back down and return their books. Now they're arguing over who gets to put what books in the slot. With enough patience, we make it to the second floor and head over to the chapter book section to find HD and JP a few new books to read. I've already lost Ms. Gail. Whatever. HD now wanders off (no, he probably ran off after I told him to settle down) as I'm helping JP to locate his Magic Tree House books. Found Ms. Gail pulling chapter books off the shelves and struggling to put them back. Lost JP while helping her, all the while keeping my eyes peeled for the third kid who hasn't been spotted for 10 minutes. Let's wander over to the story book section and hopefully find HD and a few cat books for Ms. Gail. Found the cat books, found JP again, and I can hear Ms. Gail now a few rows down exclaiming about the princess book she found. Oh and look who we have here...HD wanders over to us, like he hasn't been lost for the last fifteen minutes. "Oh I was just playing on the computers over there." You know, with the headphones cranked up, completely zoning in on "You said to go calm down..." Ideas before actions dude. Tell me where you're going. Now JP has wandered off again, but they seem to have a sixth sense and know when mom is leaving so all three unite with me as I'm checking out books, just in time to argue over who gets to place the books on the scanner and who's typing in the code... 

We've been at the library for all of twenty minutes and it's not time to go home yet so I reluctantly take them to a park downtown that we hadn't explored yet. I'm already on edge over all the running at the library and the whining, but the weather is soo nice out so I suck it up and pay $2 for parking and we (the kids) sprint to the park. I sat on the bench and watched them play for a while and could see HD getting back into the yellow zone. He yellow zoned at the library, but used the computer to help him calm down get back to the green zone. Since we're at the park, I don't so much care what he does, as long as he's nice to the other kids around him, and doesn't start throwing sand around. He carried on about his ways as I pushed Ms. Gail in the swing and kept eyes on JP. Out of nowhere, I watched HD stop playng and start wandering off like a zombie so I took Ms. Gail out of the swing and had her go play while I followed HD, as some distance behind. By the time I caught up to him, he had got himself cozy in a patch of grass that was shaded by several trees. I joined him on the ground and we looked up at the trees and the clouds together for a few minutes. "What are you doing over here?" "Oh I just needed a little break." And now I'm trying not to cry. Just when I'm really starting to wonder if OT is even helping him, he pulls this number on me and he's back in green zone playing nicely. (I'm ending my story there, before I get worked up again thinking about how I thought I lost JP when tending to HD. The struggle is real.)

OT is paying off. We might go broke trying to pay for it, but it's working. My wild child is starting to self regulate that my dear friends is priceless! I'm going to go get a tissue now. My baby is growing up!